Organization
COUNTRY CLUB CENTER HOMES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL ADAMIC (CORP CONTROLLER)
(330) 239-3597
Entity
Organization
Contact information
Practice address
860 E IRON AVE, DOVER, OH 44622-2031
(330) 343-5568
Mailing address
860 E IRON AVE, DOVER, OH 44622-2031
(330) 343-5568
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/14/2021
Last updated
01/14/2021
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